PubMed Health⌕ Search

Biomedical subjects

M D Goldman

Publications and source records attributed to M D Goldman.

63 records · Page 4Linked to original sources
PubMed1978

Mechanics of the human diaphragm during voluntary contraction: statics.

We related diaphragm electromyographic activity (Edi) to transdiaphragmatic pressure (Pdi) in man during graded inspiratory efforts. Estimates of rib cage and abdominal volume displacements were based on their anteroposterior (AP) diameter changes. The diaphragm was assumed to contract isometrically when subjects performed inspiratory efforts against a closed airway at specified abdominothoracic configurations, increasing Edi and Pdi while holding lung volume and rib case and abdominal AP diameters constant. The relationship between Pdi and Edi depends primarily on abdominothoracic configuration rather than lung volume. For equal increments in lung volume, the Pdi developed at constant Edi is four to eight times more sensitive to changes in abdominal than in rib cage AP diameter. We demonstrate an isofunctional state of the diaphragm at different lung volumes, when increases in lung volume and rib cage AP diameter are compensated for by slight decreases in abdominal AP diameter, resulting in a constant relationship between Edi and Pdi. We conclude that diaphragm shortening is reflected more directly in abdominal displacement than in lung volume change.

Abdominal Muscles↗
PubMed1978

Mechanics of the human diaphragm during voluntary contraction: dynamics.

We determined the static, isometric relationship between diaphragmatic EMG (Edi) and transdiaphragmatic pressure (Pdi) in man at specified abdominothoracic configurations, assessed with magnetometers. During inspiratory airflow, measurements of Edi and Pdi were taken as the respiratory system passed through the same configuration as obtained during the static isometric contractions, allowing a comparison of static and dynamic contractions of the diaphragm at a given length and curvature. When voluntary inspiratory maneuvers are performed with no associated outward displacement of the abdominal wall, or with slight inward displacement, the Pdi developed dynamically is the same as that developed statically at a given Edi. When outward movement of the abdominal wall occurs during inspiratory airflow, the Pdi developed dynamically depends on the rate of abdominal displacement, not on overall inspiratory airflow rate. We conclude that the velocity of shortening of the diaphragm increases directly as the rate of abdominal displacement. We construct a pressure-flow analogue of the force-velocity relationship for the diaphragm and discuss the functional implications of these observations in relation to spontaneous breathing.

Adult↗
PubMed1978

Vocal cord closure. A cause of upper airway obstruction during controlled ventilation.

Studies of vocal cord function were undertaken in a quadriplegic patient requiring ventilatory assistance, and in 2 normal subjects during controlled ventilation in a tank-type respirator. When the patient and the normal subjects relaxed and made no conscious effort to assist the respirator, the vocal cords were observed to close during inspiration and a large pressure gradient (12 to 19 cm H2O) developed across the cords. When the subjects made a slight inspiratory effort ("assist" mode), the cords opened widely during inspiration. There were large increases in flow and tidal volume in the "assist" mode compared with passive ventilation. Measurements of transdiaphragmatic pressure and esophageal pressure showed that these variables did not increase with the slight assist. Thus, increase in ventilation during the "assist" mode appeared to be due to alleviation of inspiratory obstruction at the level of the vocal cords. The same phenomenon was observed in the patient during phrenic nerve pacing. A pacemaker was designed to be triggered by the electromyographic impulse from an accessory muscle of respiration. In this manner, vocal cord opening could be coordinated with the mechanical assist given by the phrenic nerve pacer.

Adult↗
PubMed1977

A digital computer technique for analyzing respiratory muscle EMG's.

A method is described for extracting from the electromyograms of respiratory muscles a continuous signal which has primarily the periodicity of respiratory pressure and flow wave forms. The EMG is first band-pass-filtered from 50 to 500 Hz, then digitized, full-wave rectified, passed through a nonlinear voltage window to reduce noise (particularly ECG) artifacts, then low-pass filtered with a digital continuous, or moving, averager. An average wave form corresponding to one respiratory cycle is produced by ensemble averaging of the wave forms from several consecutive breaths. Diaphragmatic electromyograms from a human and from a rabbit are processed in this manner, and the effect on the processed wave forms of changes in inspired CO2 and of a change in end-expiratory lung volume are demonstrated.

Animals↗
PubMed1976

Dynamics of the chest wall during speech production: function of the thorax, rib cage, diaphragm, and abdomen.

Anteroposterior diameters of the rib cage and abdomen and esophageal and gastric pressures were measured in normal subjects in upright and supine body positions during respiratory maneuvers and utterance tasks. Data were charted in relative motion diagrams and various motion-pressure diagrams which enabled graphic solution for muscular pressures exerted by the chest wall and individually by the thorax, rib cage, diaphragm, and abdomen during utterances. Behaviors of the chest wall and its parts were found to depend upon lung volume, utterance loudness, body position, and utterance task. For utterances encompassing most of the vital capacity, chest wall effort was at first net inspiratory and later net expiratory. The former was governed predominately by the rib cage and the abdomen in the upright body position and by the diaphragm in the supine position. For conversational speech, chest wall effort was continuously expiratory, control being vested in the rib cage and the abdomen in the upright body position and typically in the rib cage alone in the supine position. Mechanisms operating during the utterances are discussed, particularly those involved with conversational speech production. We conclude that the abdomen occupies an especially important role in running conversational speech in that it mechanically tunes the diaphragm to increase the latter's inspiratory efficiency and thus enables man to minimally interrupt his ongoing speech for needed inspiratory pauses. We also discuss the relevance of our findings to clinical endeavors.

Abdomen↗
PubMed1976

Mechanical work of breathing derived from rib cage and abdominal V-P partitioning.

Estimates of the mechanical work of breathing derived from measurements of separate rib cage and abdominal volume displacements, each plotted against transthoracic pressure, include the elastic cost of chest wall distortion which may occur during breathing. Inspiratory work is partitioned between the diaphragm and the rib cage musculature by adding measurements of transabdominal pressure. The mechanical work of breathing derived from separate rib cage and abdominal volume-pressure (V-P) tracings (the sum of work done by the diaphragm, rib cage, and abdominal musculature) is compared with ventilatory work estimated from the Campbell diagram (which does not include any distortional work). During resting breathing the two estimates are closely comparable, consistent with little or no distortion of the chest wall during quiet breathing. As ventilation increases, the estimate developed from rib cage and abdominal tracings reveals systematically greater mechanical work than is estimated from the Campbell diagram, consistent with distortion of the chest wall from the relaxed thoracoabdominal configuration at higher levels of ventilation. At ventilations achieved during exercise, the Campbell diagram may underestimate the work of breathing by up to 25%.

Abdomen↗